Outline

Objective: Permanent neurologic deficits or death caused by cerebral vasospasm (CVS) remains a challenging problem after subarachnoid haemorrhage (SAH). Treatment by an induced hypertension represents a widely accepted conventional therapy of CVS. However, the risk of this hypertension in the presence of unsecured intracranial aneurysms concerning a re-bleeding is not well characterized so far and represents a limitation of this therapy. Therefore, the aim of the present study was the assessment of the safety of the induced hypertension in patients with unsecured aneurysms.

Methods: Over a 10-year period, patients suffering from SAH, requiring hypertensive therapy due to CVS were entered into a prospectively conducted database. Patients harbouring additional unsecured aneurysms and requiring Triple-H therapy due to cerebral vasospasm were identified. Any event of bleeding or re-bleeding was recorded.

Conclusions: The present data suggests that hyperdynamic therapy is safe. Considering the risk of infarction by delayed CVS, induced hypertension should not be omitted because of unsecured aneurysms, although further studies are needed, as the number of patients available is limited.